by Janie Henker | Photography by Dave Barfield<\/p>\n
In Patti Seagraves\u2019 nearly four years as a family medicine physician assistant (PA-C) in the greater Tallahassee area, she has seen and treated almost every health condition \u2014 from sinus infections and ankle sprains to diabetes and heart disease.<\/p>\n
But things look very different from the perspective of a new mom, even one with medical training.<\/p>\n
Patti had a picture-perfect pregnancy right up until she began to develop symptoms of preeclampsia, a potentially life-threatening complication that causes high blood pressure and can affect the kidneys and other organs. At 34 weeks, Patti\u2019s obstetrician made the decision to deliver the baby via cesarean section as her condition began to worsen and the risk to mom and baby grew.<\/p>\n
Patti gave birth to a healthy baby girl, Piper Lauren, in September. Because Piper was born early, she required a two-week neonatal intensive care unit stay at Tallahassee Memorial HealthCare (TMH), but appeared perfectly healthy.<\/p>\n
When Piper was nearly six weeks old, Patti began to see changes in her baby.<\/p>\n
\u201cI noticed Piper\u2019s feeding was taking longer and she wasn\u2019t taking in as much,\u201d she said. \u201cBut she\u2019s a baby, and babies change their schedules. My husband and I weren\u2019t too concerned at first.\u201d<\/p>\n
Their concern grew when Piper\u2019s feeding issues continued, and she spit up a lot when she did eat. \u201cShe was breathing pretty fast and sleeping a lot more,\u201d Patti said. \u201cWe knew something wasn\u2019t right.\u201d<\/p>\n
The new parents had a baby monitor that included a device to track an infant’s heart rate and oxygen levels. \u201cPiper\u2019s oxygen saturation levels were in the high 80s and low 90s at the time,\u201d Patti said. \u201cI knew that wasn\u2019t good, and I told my husband we needed to take her to the ER.\u201d<\/p>\n
Doctors at TMH ordered a chest X-ray and bloodwork. But when Piper\u2019s condition continued to worsen, they called in Thomas Truman, MD, pediatric critical care physician at Tallahassee Memorial HealthCare, who arrived at 3 am that day. Piper\u2019s oxygen saturation levels were now down to the low 80s and she wasn\u2019t resting and was struggling to breathe.<\/p>\n
\u201cMost babies at this age with breathing troubles are suffering from either a viral or bacterial respiratory illness that irritates the airways or lungs,\u201d said Dr. Truman. \u201cWhen Piper didn\u2019t respond well to respiratory support, I explained to her parents that I was concerned it was potentially a problem with her heart and asked Dr. Vining to evaluate her.\u201d<\/p>\n
Mac Vining, MD, a pediatric cardiologist with Wolfson Children\u2019s Specialty Center at Tallahassee Memorial HealthCare, was called in. It wasn\u2019t the first time Dr.
\nVining and Patti had met: she and her colleagues at Tallahassee Primary Care Associates (TPCA) had attended several of Dr. Vining\u2019s continuing medical education events and the two had established a close professional relationship.<\/p>\n
\u201cI didn\u2019t realize it was Patti until I walked in the room,\u201d Dr. Vining said. \u201cWhen I was briefed on Piper\u2019s symptoms that morning, I was initially very concerned she had a congenital heart defect. In babies that age, an inability to feed is one of the most concerning issues related to congenital heart disease because feeding is how babies use most of their energy.\u201d<\/p>\n
Congenital heart disease is the most common birth defect, affecting nearly 1 in 100 newborns in the U.S.<\/p>\n
To determine if his diagnosis was correct, Dr. Vining performed an echocardiogram, a sonogram of the heart\u2019s chambers, valves, walls and the blood vessels. The echocardiogram showed Piper\u2019s heart was enlarged and she also had a bicuspid aortic valve that was severely narrowed, impacting her body\u2019s ability to regulate blood flow from the heart into the aorta.<\/p>\n
A Tallahassee-Jacksonville connection<\/strong><\/p>\n Concerned the baby was so young and in such distress, Dr. Vining knew time was of the essence.<\/p>\n He reached out to his colleagues in Jacksonville, pediatric cardiologists Robert English, MD, and Brandon Kuebler, MD, with the UF Health Pediatric Cardiovascular Center affiliated with Wolfson Children\u2019s Hospital. The three children\u2019s heart specialists were in agreement, and Dr. Kuebler immediately arranged for the baby to be transferred to Wolfson Children\u2019s via the Kids Kare Mobile ICU.<\/p>\n Piper arrived in Jacksonville that afternoon, with an expert cardiac team standing by. Dr. English remembered: \u201cPiper was in critical condition with severe aortic valve stenosis, meaning her heart could not push blood through the aortic valve to get to the body. Her heart was failing, and she needed immediate treatment.\u201d<\/p>\n Dr. Kuebler performed an echocardiogram to confirm the diagnosis before sending Piper to the Cardiac Catheterization Lab, where Dr. English performed an interventional procedure to dilate the baby\u2019s narrowed aortic valve.<\/p>\n \u201cOne of Piper\u2019s cardiac nurses, whose name is also Patty, was with us from the Cath Lab to the Cardiovascular ICU (CVICU),\u201d Patti remembered. \u201cShe called us when the procedure started, part-way through and when it was finished.<\/p>\n \u201cThen Patty took us down to the Cath Lab so Dr. English could show us pictures of our baby\u2019s heart and tell us how she was doing,\u201d she added. \u201cSince I\u2019m a PA, After a short stay in the CVICU at Wolfson Children\u2019s, Piper was discharged, and the Seagraves family was able to return to Tallahassee, where Patti is now a Heart care near home<\/strong><\/p>\n Fortunately, Piper is able to have her follow-up appointments with Dr. Vining at Wolfson Children\u2019s Specialty Center at Tallahassee Memorial HealthCare through an affiliation agreement between the major Big Bend area health system, the Northeast Florida children\u2019s hospital, Although Patti never expected she or her family would need the pediatric specialty services that are part of the affiliation, she\u2019s relieved it was there for Piper.<\/p>\n \u201cTallahassee is a large city, the capital of Florida, but we were lacking in some pediatric specialty services before this affiliation,\u201d she said. \u201cIf these services weren\u2019t here, we would\u2019ve had to travel three to four hours to Jacksonville to get the outpatient care Piper needed. That\u2019s not easy when you have a little one. When you have specialty care in Tallahassee, you bring local families a lot of comfort, so this is a phenomenal resource.\u201d<\/p>\n
\nI wanted to understand what Piper\u2019s heart looked like when he was in there and what he found. Right after the procedure, Piper\u2019s oxygen levels returned to normal. And all of this took place within 12 hours from diagnosis in Tallahassee to treatment in Jacksonville!\u201d<\/p>\n
\nstay-at-home mom.<\/p>\n
\nand Tallahassee Primary Care Associates.<\/p>\n